Supervisor, Enhanced Care Management RN (Remote Options)

Date: Jan 26, 2023

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 8434 

 

Position Summary/Position

 

Under the general supervision of the Manager, Enhanced Care Management, the Supervisor, Enhanced Care Management will be responsible to assist in program development and implementation of the care management operations, clinical focus on behavioral health concerns of the Member. The Supervisor is responsible for supporting overseeing daily operations of the care management teams which will also include administrative and operational oversight. This position engages the care Team Members, to work collaboratively to build and maintain high levels of engagement, as well as excellent Member experience. This position will oversee RNs, LCSWs, coordinators and CHWs.

Major Functions (Duties and Responsibilities)

 

1. Develop effective relationships with co-workers, direct reports, and community partners, modeling excellent interpersonal skills and collaboration in working toward job duties and goals.
2. Model the importance of member and Team Member experience and engagement, through collaboration with other leaders within IEHP to develop processes and workflows that foster service improvements. 
3. Promote the importance of ECM and Community Support Services and coach team member to utilize the service to improve and maintain the overall health of IEHP Members. 
4. Work closely with the Enhanced Care Management leadership to develop effective workflows and processes that comply with all IEHP, state and federal regulatory.  
5. Provide leadership, support, and administrative supervision of Team Members, to ensure delivery of high-quality, cost-effective services to Members.
6. Proactively recognize problematic or risk areas and help develop effective and efficient solutions in conjunction with the Enhanced Care Management Leadership Team.
7. Professionally and collaboratively interface with Utilization Management Department, Member Services, BH&CM and other IEHP internal teams to resolve issues and establish workflow processes to ensure delivery of high-quality services to our members.
8. Become proficient in all electronic medical management systems (e.g., MedHok and Care Director) to assist in training of new staff members.
9. Professionally represent the department at selected IEHP meetings including external events as necessary.
10. Review Team Member daily productivity charts.
11. Conduct Team Member monthly chart audits.
12. Attend team huddles, and monthly PCP and team Systematic Case Review meeting.
13. Review Enhanced Care Management Data Reports and Quality metrics to ensure Teams are reaching goals and quality of care is achieved for ECM members. 
14. Identify, develop, and implement quality improvement activities to improve outcome metrics.
15. Assist as a liaison between ECM Providers and IEHP. 
16. Conduct all relevant administrative duties as required.
17. Support Team Member to resolve deficits within the department when approached and when identified.
18. In absence of a team’s clinician, the supervisor will provide temporary support to the team. 
19. Provide supervision as necessary, consulting on high-risk cases and providing direction to Team Members.
20. Review and update departmental policies and procedures as necessary in partnership with the Enhanced Care Management leadership.

Major Functions (Duties and Responsibilities) Cont

 

21. Collect and gather data to support the role of the manager to mentor and coach team members. 
22. Facilitates case conferences to ensure safe transitions of care as Member moves through various stages of treatment
23. Educates and provide on-going supports to all Team Members in order to assist IEHP Members to reach and maintain good health. 
24. Educate, coach and support all Team Member to work in partnership with hospitals, SNF and all relevant Provider when transition a member from one level of care to another. 
25. Work with Team Members to ensure a smooth close loop transition of care, that promotes and sustains the wellbeing of all our members.
26. Work in partnership with ECM providers to improve quality metrics to align with the Population Health Management (PHM) Bold Goals 50x2025
27. Participate actively in LEAN activities.

Supervisory Responsibilities

Leader: Administers Hires, Terminations, and Performance Reviews

Experience Qualifications

 

Three (3) years or more experience in acute care or Behavioral Health Care field. Two (2) years or more in a lead or supervisory capacity.

Preferred Experience

Education Qualifications

 

Master’s degree in Nursing, Clinical Counseling and/or Social Work or in a related field from an accredited institution is required.


INTERNAL CANDIDATES ONLY: Candidates who are actively enrolled in a Master’s degree program at an accredited institution and who have completed half or more of the course work may be considered. If selected for this position, the offer would be contingent on the internal candidate completing the Master’s degree within 12 months of accepting the offer.

Preferred Education

Professional Certification

Professional Licenses

 

Possession of an active, unrestricted, and unencumbered:
Registered Nurse (RN) license issued by the California BRN required.
OR
Clinical Social Worker (LCSW) or Marriage and Family Therapist (LMFT) license issued by the California Board of Behavioral Sciences required.

Drivers License Required

Yes, must have a valid California Driver's license and valid automobile insurance. Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points.

Knowledge Requirement

 

Deep understanding and knowledge of services for Members experiencing following: 
- Homelessness
- High Utilizers with frequent hospital admissions, short -team Skilled Nursing Facility stays and/or Emergency Room visits. 
- Serious Mental Illness (SMI)
- Substance use Disorder (SUD) and 
- Adults, youth and children transitioning from incarceration. 
The knowledge to supports mental health and substance use conditions, including acute /chronic medical health needs. Awareness of the impact of unmitigated bias and judgement. Skilled in evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies. Understanding of and sensitivity to multi-cultural community. Knowledge of whole person health and the effects of social deprivation.

Skills Requirement

 

Highly skilled interpersonally, with excellent relationship skills. Highly skilled in interpersonal communication, including resolving conflict with co-workers/Team Members. The ability to perform at an intermediate level of Excel and Word is preferrable. Skillful in informally and formally sharing expertise.

Abilities Requirement

 

Ability to work well in leading teams and providing supportive assistance as needed. Must have the skills and resilience to tolerate change as needed and when required to promote improvements.  

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

Supervisor will work remotely and, in the field, as needed to meet with Team Members/Providers as needed. Minimal physical activity; may include standing and repetitive motion.
Position is eligible for telecommuting/remote work location model upon completing the necessary steps and receiving HR approval. The incumbent approved to telecommute may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs determined by IEHP leadership.

Work Model Location

Telecommute

Physical Requirements

Keyboarding: Traditional - FREQUENTLY
Keyboarding: Touch-Screen - FREQUENTLY
Keyboarding: 10-Key - FREQUENTLY
Hearing: One-on-One - FREQUENTLY
Communicate: Information/ideas verbally - FREQUENTLY
Near Visual Acuity - FREQUENTLY
Sitting - CONSTANTLY
Indoors - FREQUENTLY
Lighting - CONSTANTLY
Memory - FREQUENTLY
Regular contacts: co-workers, supervisor - FREQUENTLY
Understand and follow direction - FREQUENTLY
Regular and reliable attendance - CONSTANTLY
Use of computer mouse - FREQUENTLY

A reasonable salary expectation is between $103,708.80 and $132,225.60, based upon experience and internal equity.

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles